Forms and brochures
A list of our benefit application forms and brochures.
It is better to contact us before you apply for assistance. That way we can learn about your circumstances and talk to you about the types of assistance you might get.
We can grant you most types of financial assistance that you’re entitled to from the date you first contact us if you complete your application within 20 working days of that date.
Our forms and brochures are in RTF, MS Word, or PDF format. You will need Adobe Acrobat Reader to view PDF files. This can be downloaded for free at the Adobe website.
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
A
Accommodation Supplement Application Form [PDF, 316.82KB]
Application for New Zealand Payment Overseas [PDF, 87.5KB]
Appointment of an Agent Form [PDF, 123.72KB]
Are you going overseas? [RTF, 117.77KB]
A guide to what happens with your income support if you are going overseas.
Are you going overseas? [PDF, 310.66KB]
Are you starting work? [RTF, 64.6KB]
Find out how we can help through In Work Support.
Are you starting work? [PDF, 160.68KB]
B
Benefit rates table 1 April 2009 [RTF, 344.8KB]
Benefit rates table valid at 1 April 2009.
C
Child Disability Allowance Application Form [PDF, 134.76KB]
Childcare & OSCAR Subsidy - Change of Circumstances Form [PDF, 87.24KB]
Childcare & OSCAR Subsidy Application Form [PDF, 237.6KB]
Civil Defence Payments to Evacuees Application Form [PDF, 89.84KB]
Civil Defence Payments to Hosts Application Form [PDF, 81.09KB]
Civilian Amputee Assistance Application Form [PDF, 143.91KB]
Community Services Card [PDF, 240.52KB]
How a Community Services Card can help you with the costs of health care.
Community Services Card [RTF, 95.34KB]
Community Services Card Application Form [PDF, 138.42KB]
Continuation of the Rural Assistance Payment Application Form [PDF, 76.19KB]
D
Disability Allowance - Medical Alarm Costs Self-Assessment Form [PDF, 62.01KB]
Disability Allowance Application Form [PDF, 316.82KB]
Disability Allowance Application Form (for clients already receiving Work and Income assistance) [PDF, 114.66KB]
Disability assistance [PDF, 223.94KB]
A guide about the Disability Allowance, Special Disability Allowance, Modification Grant and the Child Disability Allowance.
Disability assistance [RTF, 85.52KB]
Domestic Purposes Benefit Application Form - Caregiver [PDF, 355.43KB]
Domestic Purposes Benefit Application Form - Sole Parents [PDF, 283.93KB]
Domestic Purposes Benefit Application Form - Women Alone [PDF, 175.03KB]
Domestic Purposes Benefit Caring for Sick or Infirm (DPB - CSI) - Carer Statement [Word, 93KB]
The Carer Statement is an application form that is part of the assessment process for retrospective applications for Domestic Purposes Benefit - Care of Sick or Infirm.
Domestic Purposes Benefit Caring for Sick or Infirm (DPB - CSI) - Carer Statement [RTF, 895.25KB]
Domestic Purposes Benefit Caring for Sick or Infirm (DPB - CSI) Retrospection factsheet [RTF, 53.45KB]
Domestic purposes and widow's benefits [PDF, 210.64KB]
Financial assistance for sole parents, some women living alone and caregivers.
Domestic purposes and widow's benefits [RTF, 132.05KB]
E
Early Learning Payment Application Form [PDF, 290.97KB]
Emergency Benefit Application Form [PDF, 341.92KB]
Emergency Maintenance Allowance Application Form [PDF, 190.04KB]
Extra Help Application Form [PDF, 316.82KB]
Extra help for people receiving New Zealand Superannuation or Veteran's Pension factsheet [PDF, 137.56KB]
Extra help for people receiving New Zealand Superannuation or Veteran's Pension factsheet [RTF, 95.53KB]
F
Financial assistance for live organ donors [RTF, 62.41KB]
Financial assistance for people donating a kidney or liver tissue for transplant within New Zealand.
Financial assistance for live organ donors [PDF, 214.38KB]
Financial assistance when you're having a baby [RTF, 60.53KB]
Help available if you're having a baby.
Financial assistance when you're having a baby [PDF, 230.19KB]
Finding job leads worksheet [RTF, 106.58KB]
Tips on how to go about finding job leads and making contact with employers.
Finding job leads worksheet [PDF, 148.88KB]
Funeral Grant Application Form [PDF, 112.02KB]
Funeral Grant factsheet [PDF, 136.91KB]
Help with some of the funeral costs of someone close to you who has died.
Funeral Grant factsheet [RTF, 61.16KB]
G
Getting Netherlands pensions in New Zealand [PDF, 169.29KB]
Answers to questions about getting Netherlands pensions in New Zealand.
Getting United Kingdom pensions in New Zealand [PDF, 168.56KB]
Answers to questions about getting United Kingdom pensions in New Zealand.
Getting in touch with us [PDF, 75.99KB]
Find the easiest way for you to contact us.
Getting in touch with us [RTF, 100.9KB]
Getting work skills and experience [PDF, 403.46KB]
Training and subsidies to help you get the job you want.
Getting work skills and experience [RTF, 58.8KB]
Going Overseas factsheet [RTF, 93.81KB]
H
Help for kinship carers [RTF, 129.27KB]
A guide for people who are raising someone else's child.
Help for kinship carers [PDF, 405.43KB]
Help when you're working [RTF, 162.25KB]
A guide for people who are working or starting work.
Help when you're working [PDF, 307.7KB]
Help with childcare costs [RTF, 116.45KB]
A guide for parents and caregivers about assistance which helps with childcare costs.
Help with childcare costs [PDF, 270.83KB]
Home Help Payments Application Form [PDF, 133.75KB]
How can we help you [PDF, 197.8KB]
A quick guide to the support you and your family may be able to get from us.
How can we help you [RTF, 165.03KB]
How to avoid benefit fraud [RTF, 56.3KB]
How you can get your correct entitlement and avoid benefit fraud by keeping us up to date with your personal situation.
How to avoid benefit fraud [PDF, 350.63KB]
I
Income Tested Superannuation Fact Sheet [PDF, 134.77KB]
Information concerning income tested superannuation.
Independent Youth Benefit [PDF, 210.64KB]
A weekly payment which helps 16 and 17 year-olds who can't live with their parents and are not supported by them or anyone else.
Independent Youth Benefit [RTF, 70.63KB]
Independent Youth Benefit Application Form [PDF, 178.87KB]
Information Matching [RTF, 41.7KB]
A guide to how we match records to find benefit fraud.
Information Matching [PDF, 51.16KB]
International Custody Dispute Payment Application Form [PDF, 182.84KB]
International Custody Dispute Payment factsheet [PDF, 58.57KB]
International Custody Dispute Payment factsheet [RTF, 54.82KB]
International Social Security Agreements [PDF, 95.28KB]
A guide to New Zealand's social security agreements with other countries.
International Social Security Agreements [RTF, 72.37KB]
International Social Security Agreements (Dutch text) [RTF, 79.16KB]
International Social Security Agreements (Dutch text) [PDF, 96.1KB]
Invalid's Benefit [PDF, 218.81KB]
A guide for people with a permanent injury, sickness or disability.
Invalid's Benefit [RTF, 88.17KB]
Invalid's Benefit Application Form [PDF, 341.53KB]
L
Limited Service Volunteer (LSV) [RTF, 54.32KB]
A six-week motivational course run by the New Zealand Defence Force.
Limited Service Volunteer (LSV) [PDF, 924.3KB]
Living Alone Payment Application Form [PDF, 100.44KB]
M
Managing your money [RTF, 134.87KB]
What it means to have a budget.
Managing your money [PDF, 327.39KB]
Missionary work, volunteer services abroad work and presence factsheet [RTF, 68.88KB]
How voluntary or humanitarian work affects your pension entitlements.
N
Need extra help with costs [RTF, 130.58KB]
A guide to allowances and extra payments for people on a benefit.
Need extra help with costs [PDF, 311.52KB]
New Zealand Superannuation [PDF, 300.2KB]
Financial assistance for people aged 65 years or more.
New Zealand Superannuation [RTF, 84.23KB]
New Zealand Superannuation Application Form [PDF, 336.08KB]
New Zealand Superannuation Application Form - Partner [PDF, 296.48KB]
O
OSCAR Subsidy - Additional School Holiday Programme Application Form [PDF, 74.76KB]
Complete this form if your child is attending more than one programme during the school holidays.
OSCAR Subsidy - Additional school holiday programme application form [PDF, 74.88KB]
The application form to use if you are applying for an OSCAR Subsidy and your child is attending more than one programme during the school holidays.
OSCAR programmes and OSCAR Subsidy [PDF, 235.71KB]
A quick guide about OSCAR programmes and OSCAR Subsidy.
OSCAR programmes and OSCAR Subsidy [RTF, 55.16KB]
OSCAR programmes and OSCAR Subsidy (Maori text) [PDF, 252.4KB]
OSCAR programmes and OSCAR Subsidy (Maori text) [RTF, 58.77KB]
Orphan's and Unsupported Child's Benefit [RTF, 77.01KB]
A guide for caregivers who are raising someone else's child.
Orphan's and Unsupported Child's Benefit [PDF, 256.63KB]
Orphan's and Unsupported Child's Benefit Application Form [PDF, 126.42KB]
Other income you earn factsheet [RTF, 57.3KB]
What you need to know if you get other income and financial assistance from us.
Other income you earn factsheet [PDF, 76.92KB]
Our services and standards [PDF, 180.96KB]
A guide to the services we offer and what you can expect from us.
Our services and standards [RTF, 106.36KB]
P
PACE 2008 resource pack [PDF, 227.49KB]
Resource pack containing information about assistance and funding available for people who are looking for work in the arts and cultural sector.
PACE 2008 resource pack [Word, 770.5KB]
PACE 2008 resource pack [RTF, 6.59MB]
Payment options for overseas pensions [PDF, 332.3KB]
A guide for people who qualify for a pension from the United Kingdom, the Netherlands, Australia, Jersey, Guernsey, or the Republic of Ireland.
Payment options for overseas pensions [RTF, 89.86KB]
R
ReStart Application Form [PDF, 163.89KB]
ReStart Factsheet [RTF, 55.15KB]
Help for people who have been made redundant.
ReStart Factsheet [PDF, 78.71KB]
Redundancy Support Factsheet for Employees [PDF, 138.73KB]
Help for workers affected by redundancy.
Reimbursement of Health Overcharges Application form [PDF, 116.66KB]
Relationships and income assistance [PDF, 381.79KB]
Things you need to know about relationships when getting income assistance.
Relationships and income assistance [RTF, 56.87KB]
Repayment Authority Form [PDF, 123.32KB]
This form provides you with different options on how you can repay Work and Income.
Residency requirements for New Zealand benefits and pensions factsheet [RTF, 73.98KB]
Residential Care Loans factsheet [PDF, 67.79KB]
Helps older people who can’t get Residential Care Subsidy to pay for the cost of their contracted care services.
Residential Care Loans factsheet [RTF, 47.76KB]
Residential Care Subsidy [PDF, 277.18KB]
Financial assistance for people in rest homes or hospital.
Residential Care Subsidy [RTF, 124.18KB]
Retired and going overseas [PDF, 280.92KB]
A guide to receiving New Zealand Superannuation or the Veteran's Pension overseas.
Retired and going overseas [RTF, 151KB]
Review Rights and Responsibilities flyer [PDF, 81.17KB]
Information concerning your rights and responsibilities in dealing with Work and Income.
Review of Decision Application Form [PDF, 247.75KB]
Rural Assistance Payment Application Form [PDF, 164.45KB]
Rural assistance payments [PDF, 88.61KB]
A payment to meet the essential living expenses of farming families affected by an adverse event such as a flood, drought or other natural disaster.
Rural assistance payments [RTF, 101.67KB]
S
Seasonal work [PDF, 279.66KB]
Finding seasonal work and how we may be able to help.
Seasonal work [RTF, 70.59KB]
Services for Deaf, Hearing Impaired and Speech Impaired people [PDF, 70.23KB]
We have a centralised team who can quickly respond to the deaf or those who have hearing or speech impairments.
Sickness Benefit [RTF, 74.1KB]
A guide to the sickness benefit which helps people who aren't currently working, or are working less hours, because they are sick, injured, disabled or pregnant.
Sickness Benefit [PDF, 268.03KB]
Sickness Benefit Application Form [PDF, 357.18KB]
Sickness Benefit parents income verification form [PDF, 95.93KB]
Social security agreement with Australia [PDF, 615.37KB]
A guide for getting benefits or pensions if you have lived, live or are going to live in New Zealand or Australia.
Social security agreement with Australia [RTF, 228.67KB]
Social security agreement with Canada [RTF, 169.55KB]
A guide for getting benefits or pensions if you have lived, live or are going to live in New Zealand or Canada.
Social security agreement with Canada [PDF, 683.27KB]
Social security agreement with Denmark [PDF, 796.06KB]
A guide for getting benefits or pensions if you have lived, live or are going to live in New Zealand or Denmark.
Social security agreement with Denmark [RTF, 188.01KB]
Social security agreement with Greece [RTF, 184.08KB]
A guide for getting benefits or pensions if you have lived, live or are going to live in New Zealand or Greece.
Social security agreement with Greece [PDF, 695.89KB]
Social security agreement with Ireland [PDF, 699.43KB]
A guide for getting benefits or pensions if you have lived, live or are going to live in New Zealand or Ireland.
Social security agreement with Ireland [RTF, 189.5KB]
Social security agreement with Jersey or Guernsey [PDF, 763.23KB]
A guide for getting benefits or pensions if you have lived, live or are going to live in New Zealand, Jersey or Guernsey.
Social security agreement with Jersey or Guernsey [RTF, 193.78KB]
Social security agreement with the Netherlands [RTF, 215.34KB]
A guide for getting benefits or pensions if you have lived, live or are going to live in New Zealand or the Netherlands.
Social security agreement with the Netherlands [PDF, 671.33KB]
Social security agreement with the United Kingdom [PDF, 316.08KB]
A guide for getting benefits or pensions if you have lived, live or are going to live in New Zealand or the United Kingdom.
Social security agreement with the United Kingdom [RTF, 180.4KB]
Social security arrangements with Pacific countries [PDF, 533.83KB]
A guide for getting benefits or pensions if you have lived, live or are going to live in New Zealand or in any of the listed Pacific countries.
Social security arrangements with Pacific countries [RTF, 114.58KB]
Special Banking Option Australia - Acceptance Form [PDF, 998.75KB]
Special Banking Option Australia - Bank Account Application Form [PDF, 187.72KB]
Special Banking Option Australia - Information Release Form [PDF, 338.98KB]
Special Banking Option Factsheet [RTF, 62.08KB]
The Special Banking Option (SBO) enables you to receive overseas and New Zealand benefits or pension payments as one regular payment.
Special Banking Option Factsheet [PDF, 73.69KB]
Special Banking Option Factsheet (Dutch text) [RTF, 78.51KB]
Special Banking Option Factsheet (Dutch text) [PDF, 103.45KB]
Special Banking Option Ireland - Acceptance Form [PDF, 676.83KB]
Special Banking Option Ireland - Bank Account Application Form [PDF, 189.29KB]
Special Banking Option Ireland - Information Release Form [PDF, 342.91KB]
Special Banking Option Jersey and Guernsey - Acceptance Form [PDF, 951.5KB]
Special Banking Option Jersey and Guernsey - Bank Account Application Form [PDF, 373.98KB]
Special Banking Option Jersey and Guernsey - Information Release Form [PDF, 313.19KB]
Special Banking Option Netherlands - Acceptance Form [PDF, 219.72KB]
Special Banking Option Netherlands - Bank Account Application Form [PDF, 156.09KB]
Special Banking Option Netherlands - Information Release Form [PDF, 718.17KB]
Special Banking Option UK - Acceptance Form [PDF, 445.9KB]
Special Banking Option UK - Bank Account Application Form [PDF, 214.35KB]
Special Banking Option UK - Information Release Form [PDF, 176.2KB]
Special Needs Grants Factsheet [RTF, 19.55KB]
Special Needs Grants are available to people who need one-off assistance to meet essential and immediate needs which they are unable to meet themselves.
Start your own business [RTF, 98.79KB]
Start your own business [PDF, 323.86KB]
Some things to think about first.
Starting your job search worksheet [PDF, 33.18KB]
Help starting your job search and planning your career.
Starting your job search worksheet [RTF, 89.47KB]
T
Taking your New Zealand Superannuation or Veteran's Pension to the Pacific [PDF, 88.05KB]
A guide to getting your New Zealand Superannuation or Veteran’s Pension when you move to certain Pacific countries.
Taking your New Zealand Superannuation or Veteran's Pension to the Pacific [RTF, 67.44KB]
Taking your New Zealand Superannuation or Veteran's Pension to the Pacific (Cook Island Maori text) [PDF, 127.35KB]
Taking your New Zealand Superannuation or Veteran's Pension to the Pacific (Cook Island Maori text) [RTF, 76.56KB]
Taking your New Zealand Superannuation or Veteran's Pension to the Pacific (Samoan text) [RTF, 110.3KB]
Taking your New Zealand Superannuation or Veteran's Pension to the Pacific (Samoan text) [PDF, 123.35KB]
Taking your New Zealand Superannuation or Veteran's Pension to the Pacific (Tongan text) [PDF, 143.05KB]
Taking your New Zealand Superannuation or Veteran's Pension to the Pacific (Tongan text) [RTF, 84.54KB]
Testing and review of overseas benefit or pension entitlements factsheet [RTF, 57.39KB]
A guide to how your, or your spouse or partner's, entitlements to overseas benefits or pensions affect your New Zealand benefit or pension.
The Great Little Cookbook [PDF, 1.06MB]
The Great Little Cookbook - hints and healthy eating on a tight budget.
The Great Little Cookbook [RTF, 282.87KB]
Training Incentive Allowance Application Form [PDF, 123.19KB]
Training Incentive Allowance factsheet [PDF, 72.8KB]
Training Incentive Allowance factsheet [RTF, 49.46KB]
Transition to Work Grant Application Form [PDF, 152.48KB]
Treatment of overseas pensions or benefits in New Zealand factsheet [PDF, 181.23KB]
How your overseas pensions or benefits is treated in New Zealand.
Treatment of overseas pensions or benefits in New Zealand factsheet [RTF, 76.96KB]
U
Unemployment Benefit [PDF, 268.32KB]
A guide for people who are out of work.
Unemployment Benefit [RTF, 79.41KB]
Unemployment Benefit Application Form [PDF, 357.94KB]
Unemployment Benefit Re-Application Form [PDF, 131KB]
W
War Veterans' Entitlements [PDF, 305.72KB]
A guide to the War Disablement, Surviving Spouse or Partner and Veteran’s pensions.
War Veterans' Entitlements [RTF, 105.32KB]
Widows Benefit Application Form [PDF, 182.07KB]
Writing your CV worksheet [RTF, 81.77KB]
Some guidelines to follow when writing your CV.
Writing your CV worksheet [PDF, 39.82KB]
Y
Young Parent Childcare Payment Application Form [PDF, 158.44KB]
Young Parent Childcare Payment brochure [PDF, 857.85KB]
A payment which helps parents aged under 18 years who need support to pay childcare costs while they attend secondary school.